Provider Demographics
NPI:1891953089
Name:HARTMAN-MOYER, TRISH M (MSS, LCSW)
Entity Type:Individual
Prefix:
First Name:TRISH
Middle Name:M
Last Name:HARTMAN-MOYER
Suffix:
Gender:F
Credentials:MSS, LCSW
Other - Prefix:
Other - First Name:TRISH
Other - Middle Name:M
Other - Last Name:HARTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSS, LCSW
Mailing Address - Street 1:1125 BEN FRANKLIN HWY W
Mailing Address - Street 2:
Mailing Address - City:DOUGLASSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19518-1829
Mailing Address - Country:US
Mailing Address - Phone:610-385-3155
Mailing Address - Fax:
Practice Address - Street 1:1125 BEN FRANKLIN HWY W
Practice Address - Street 2:
Practice Address - City:DOUGLASSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19518-1829
Practice Address - Country:US
Practice Address - Phone:610-385-3155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-25
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0170201041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA255989S43OtherMEDICARE PTAN